Melanoma is a frequently fatal cancer that, if detected early, is relatively easily cured. This disease is rapidly increasing in frequency and has recently been identified by the National Center for Health Statistics Health Disparities Study as a high profile health disparity. Further it has been noted to occur more frequently now in both young people and Hispanic populations. We have developed a unique, proprietary and innovative self-screening imaging technology (DermAlert) that has the potential to significantly mitigate disparate melanoma outcomes by more fully involving people at-risk of melanoma in their own healthcare, and by enabling much earlier detection of new and changed pigmented lesions that may be early melanomas. The goal of this NIH grant program is to address key issues (patient related causes for the disparity and physician/insurance requirements for efficacy demonstration) for the translation of this technology into the at- risk community to realize reduction in melanoma disparity. We propose a program to research the efficacy of DermAlert imaging self screening for new and changed pigmented lesions, and to provide education that will be useful in overcoming barriers to use of the DermAlert system in affected populations. Phase I activities will include: " Conversion of DermAlert to a Spanish language resource, " Analysis of specific classes of barriers to use of imaging by groups suffering melanoma health disparities, " Development of education and outreach tools to help overcome barriers to use of self imaging screening, " Preliminary evaluation of the effect of DermAlert use on health outcomes, and " Preparation for an expanded, large scale efficacy study during Phase II. As pigmented lesions, for which change was detected by the imaging system, are biopsied, the results of those biopsies will be tabulated and statistically compared with control set of biopsies for which imaging was not a motivating factor. Using this approach it will be possible to investigate not only patient compliance in the use of the imaging system, but also its utility in helping to guide more effective biopsy decisions. This part of the project will address its efficacy and the resultant medical outcomes Measureable milestones during Phase I include the following, which can be used to help assess the viability of progressing to Phase II research: " Qualitative and quantitative identification of specific barriers to imaging that contribute to the health disparity " Preparation of an educational video for helping patients and physicians overcome barriers to use of this technology, and " Foundation and preliminary analysis of an archive of follow-up biopsy data for evaluation of efficacy of using DermAlert. Successful completion of the project will result in enhanced awareness and reduced barriers to use of a completely unique imaging protocols which will more deeply involve patients in their personal health care, contribute to earlier detection of potential melanomas, and have the power to ultimately reduce the number of unnecessary biopsies and reduce patient mortality at the hands of a serious health disparity. PUBLIC HEALTH RELEVANCE: Melanoma is a serious, and growing, public health disparity;to help combat it physicians urge people to look for new and changed pigmented moles on their skin. This is presently a very challenging task for people;however, this project will seek to reduce barriers to use of a reliable, at-home digital photography tool to assist people in finding these changes. Wide use of this technology can reduce the health disparities of melanoma.